Marc R Matthews

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Journals/Publications

• Bhogadi, S. K., Stewart, C., Hosseinpour, H., Nelson, A., Ditillo, M., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2024). Outcomes of Patients With Traumatic Brain Injury Transferred to Trauma Centers. JAMA surgery, 159(11), 1282-1288.
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  Wide variations exist in traumatic brain injury (TBI) management strategies and transfer guidelines across the country.
• Fernandez, L. G., Murry, J., Matthews, M. R., Thompson, C. L., Abdelgawad, M., & Bjorklund, R. (2024). Definitive Closure Using an Ovine Reinforced Tissue Matrix in Contaminated Penetrating Abdominal Trauma. The American journal of case reports, 25, e943188.
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  BACKGROUND Cases involving penetrating abdominal trauma may be complex and often involve damage to multiple organ systems. Synthetic, biologic, and reinforced biologic matrices/reinforced tissue matrices (RBMs/RTMs) are frequently used in hernia repair and other surgical procedures requiring reinforcement, including trauma cases that require abdominal repair. CASE REPORT The first case was a 35-year-old male patient with a stab wound (SW) to the right side of the chest and the abdomen resulting in damage to the diaphragm, epicardium, liver, and duodenum. The second case was a 22-year-old male patient who suffered multiple traumas after an automated trencher accident, including a skull fracture with exposed brain and major lacerations to the shoulder and abdomen causing a large right-flank hernia. In both cases, OviTex® (TELA Bio, Inc., Malvern, PA), a reinforced tissue matrix (RTM), was used to help obtain and maintain abdominal wall closure. We also present an institutional economic analysis using data from the author's institution with average case cost and future projections for procedure volume and product usage volume through 2021. CONCLUSIONS We report favorable outcomes in a series of patients with contaminated (CDC Wound Class III) surgical fields who underwent abdominal wall closure and reinforcement with OviTex RTM. Our work adds to the growing body of literature suggesting that reinforced biologics offer a potential alternative to biological meshes in the setting of a contaminated surgical field. Additionally, in comparison to other commonly available biologic matrices, use of OviTex RTM may be a cost-effective option to achieve abdominal wall closure even in complex cases.
• Fernandez, L. G., Orsi, C., Okeoke, B., Moudy, P., Critelli, P. A., Norwood, S., Matthews, M. R., Kim, P. J., MacEwan, M., & Sallade, E. (2024). Synergistic clinical application of synthetic electrospun fiber wound matrix in the management of a complex traumatic wound: degloving left groin and thigh auger injury. Wounds : a compendium of clinical research and practice, 36(4), 124-128.
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  Managing complex traumatic soft tissue wounds involving a large surface area while attempting to optimize healing, avoid infection, and promote favorable cosmetic outcomes is challenging. Regenerative materials such as ECMs are typically used in wound care to enhance the wound healing response and proliferative phase of tissue formation.
• Fernández, L. G., & Matthews, M. R. (2024). Clinical observations in patients with open abdomens managed with negative pressure therapy using a perforated foam dressing: a limited case series with brief literature review. Wounds : a compendium of clinical research and practice, 36(2), 61-66.
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  Emergency laparotomy has become an increasingly more frequent and expensive general surgery procedure in terms of cost and resource utilization. Primary fascial closure at the index procedure may not be feasible in many patients, requiring use of the open abdomen (OA)technique. Patients with OA are most often managed with temporary abdomen closure (TAC). Open abdomen negative pressure therapy (OA-NPT) has been shown to be an effective TAC technique, which facilitates re-exploration, protects visceral organs, mitigates fascial retraction, prevents loss of abdominal domain, and provides effective volumetric abdominal fluid management.
• Hejazi, O., Spencer, A. L., Khurshid, M. H., Nelson, A., Hosseinpour, H., Anand, T., Bhogadi, S. K., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2024). Failure to Rescue in Geriatric Ground-Level Falls: The Role of Frailty on Not-So-Minor Injuries. The Journal of surgical research, 302, 891-896.
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  The measure of mortality following a major complication (failure to rescue [FTR]) provides a quantifiable assessment of the level of care provided by trauma centers. However, there is a lack of data on the effects of patient-related factors on FTR incidence. The aim of this study was to identify the role of frailty on FTR incidence among geriatric trauma patients with ground-level falls (GLFs).
• Huang, R., Hejazi, O., Khurshid, M. H., Nelson, A., Stewart, C., Anand, T., Matthews, M. R., Okosun, S. E., Magnotti, L. J., & Joseph, B. (2024). Diversity in crisis: The impact of race and ethnicity on failure to rescue among geriatric trauma patients over the years. The journal of trauma and acute care surgery.
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  Failure to rescue (FTR) is an indicator of the quality of care provided by trauma centers. The aim of this study was to examine the trends of FTR incidence in geriatric trauma patients over the years and to determine whether race, ethnicity, and sex impact the FTR incidence.
• Khurshid, M. H., Hejazi, O., Spencer, A. L., Nelson, A., Stewart, C., Colosimo, C., Ditillo, M., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2024). A little goes a long way: A comparison of enterolithotomy versus single-stage cholecystectomy in the management of gallstone ileus. The journal of trauma and acute care surgery.
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  Gallstone ileus is an infrequent complication of cholelithiasis with no specific guidelines for its management. This study aims to compare the outcomes of patients with gallstone ileus managed with both enterolithotomy with cholecystectomy (EL-CCY) versus those managed with enterolithotomy (EL) only.
• Kim, P. J., Fernandez, L., Obst, M. A., Chaffin, A., Faust, E., Lantis, J., Couch, K., Desvigne, M., Suski, M., Kundu, N., Matthews, M., Simman, R., Murphy, C., Nierenberg, N. E., & Téot, L. (2024). Multidisciplinary expert consensus statements and recommendations for use of hypochlorous acid as a solution for negative pressure wound therapy with instillation. Wounds : a compendium of clinical research and practice, 36(4), 108-114.
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  HOCl (eg, pHAp) preserved solutions have antimicrobial properties and are considered safe and effective for wound management. NPWTi-d (or NPWTi) is an established adjunctive wound modality for a variety of wound etiologies in various anatomic locations in which an instillate solution dwells on the surface of the wound to assist in wound bed preparation. A variety of solutions have been used, including 0.9% normal saline wound cleansers and antiseptics. pHAp is growing in popularity as the solution of choice for NPWTi-d.
• Matthews, M. R., Fernández, L. G., Hermans, M. H., & Chakravarthy, D. (2024). The efficient application of instilling negative pressure wound therapy with a hypochlorous acid-preserved wound cleanser: a case series and practical advice. Wounds : a compendium of clinical research and practice, 36(5), 148-153.
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  The use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been shown to be effective in removing nonviable tissue, reducing bioburden, and promoting granulation tissue formation in acute and chronic infected wounds.
• Fernandez, L. G., Matthews, M. R., & Kim, P. J. (2023). A synthetic hybrid-scale fiber matrix for complex surgical wounds: consensus guidelines. Wounds : a compendium of clinical research and practice, 35(5), E160-E168.
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  Based on their own clinical experience and review of the available peer-reviewed data, the authors developed a consensus opinion on the use of an SHSFM for open wounds. The matrix has features such as varying pore sizes and fibers (ie, hybrid-scale) and is indicated for the treatment of open wounds. This report describes the design and utility of the SHSFM, its mechanism of action, and the methods of application, as well as clinical outcomes. The authors discuss their own experience and review of the published literature, then describe their protocols and rationale for the use of the SHSFM. These consensus statements include recommendations regarding appropriate wounds for use of the SHSFM, use of other wound therapies in conjunction with the SHSFM, reapplication rates, preparation methods, and additional discussions of appropriate use. This report is not a literature review, but rather is a statement of preliminary clinical experience. The consensus statements indicate that the SHSFM may be used to treat a variety of wounds and can be used to stage wounds to closure via skin grafts or by secondary intention.
• Fernández, L., Matthews, M., Kim, P. J., Barghuthi, L., MacEwan, M., & Sallade, E. (2023). Clinical application of a synthetic hybrid-scale fiber matrix in a pediatric trauma patient. Wounds : a compendium of clinical research and practice, 35(8), E248-E252.
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  Large soft tissue defects resulting from trauma in the pediatric population are common. MLLs are a rare subset of these injuries with no standard treatment regimen. Thorough surgical debridement of these lesions is often warranted to remove necrotic tissue and contamination, which results in a large, open soft tissue defect. STSGs may be used to provide tissue coverage; however, they have limitations, including donor site morbidity and additional surgical time and cost.
• Kim, P. J., Fernandez, L., & Matthews, M. (2023). Early experience and recommendations for the use of an automated estimator of solution volume for negative pressure wound therapy with instillation. Wounds : a compendium of clinical research and practice, 35(2), E82-E87.
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  NPWTi is a device that combines the benefits of traditional NPWT with periodic irrigation. This automated device allows for preprogrammed cycles of dwelling of a solution and negative pressure onto the wound surface. Its adoption has been hampered by the perceived difficulty of estimating the volume of solution needed per dwell cycle. A new software update includes an AESV that makes this determination for the clinician.
• Rollins, A., Ho, K., Fernandez, L. G., Lardizabal, M. A., Roth, B., O'Keefe, S. F., & Matthews, M. R. (2023). The sandwich technique for quick and efficient application of negative pressure wound therapy to the feet and hands: a case report. Wounds : a compendium of clinical research and practice, 35(1), E17-E21.
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  NPWT is a surgical dressing that combines polyurethane foam with the subsequent application of continuous or intermittent negative pressure. NPWT facilitates granulation tissue production by macrostrain, microstrain and, if desired, fluid instillation. Sealing the polyurethane foam over the wound bed is achieved using acrylic drapes; however, this can be difficult to use in some anatomic sites. Failure to achieve an effective seal can necessitate additional supplies, which has led to increased innovation in developing a more effective NPWT seal over the target wound bed. Obtaining an effective pressure seal on the feet or hands can be difficult because these anatomic sites have distinct curvature for each digit, with multiple interdigital web spaces and independent mobility. In this case report, the authors propose a technique to apply either an acrylic drape or combination acrylic and soft silicone drape utilizing the "sandwich technique" to seal NPWT foam quickly and efficiently to the feet or hands.
• Thornburg, D. A., Swanson, S., Spadafore, P., Kowal-Vern, A., Foster, K. N., & Matthews, M. R. (2023). Burn Center Patients at Risk for Upper Extremity Amputations. Plastic surgery (Oakville, Ont.), 31(3), 229-235.
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  Burn center patients present not only with burn injuries but also necrotizing infections, , frostbite, toxic epidermal necrolysis, chronic wounds, and trauma. Burn surgeons are often faced with the need to amputate when limb salvage is no longer a viable option. The purpose of this study was to determine factors which predispose patients to extremity amputations. This retrospective registry review (2000-2019) compared patients who required upper extremity amputations with those who did not. Cases were pair-matched by age, sex, percent total body surface area (%TBSA), and type/location of injury to control for possible confounding variables. There were 77 upper extremity amputee patients (APs) and 77 pair-matched non-amputees (NAPs) with the median age 45- and 43-years, %TBSA 21 and 10, respectively; second and third degree burn injuries were similar in the 2 groups. The AP group had longer hospitalizations (median 40 vs 15 days)  
• Fernandez, L. G., Norwood, S. H., Orsi, C., Heck, M., Gonzalez, K., Williams, N., Matthews, M. R., Scalea, T. M., & Swindall, R. (2022). Use of a Modified ABTHERA ADVANCE™ Open Abdomen Dressing with Intrathoracic Negative-Pressure Therapy for Temporary Chest Closure After Damage Control Thoracotomy. The American journal of case reports, 23, e937207.
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  BACKGROUND Damage control surgery (DCS) is an established emergency operative concept, initially described and most often utilized in abdominal trauma. DCS prioritizes managing acute hemorrhage and contamination, leaving the abdominal wall fascia open and covering the existing wound with a temporary abdominal wall closure, most commonly negative-pressure wound therapy (NPWT). The patient undergoes aggressive resuscitation to optimize physiology. Once achieved, the patient is returned to the operating room for definitive surgical intervention. There is limited evidence suggesting that using damage control thoracotomy within the chest cavity improves mortality and morbidity rates. Our review failed to find a case in which NPWT using ABTHERA ADVANCE™ Open Abdomen Dressing has been successfully used in the setting of thoracic trauma. CASE REPORT This case series describes 2 examples of NPWT as a form of temporary chest closure in penetrating and blunt thoracic injury. The first case was a penetrating self-inflicted stab wound to the chest. The NPWT was applied as a form of temporary thoracotomy, closure at the index surgery. The second case was a blunt injury to the chest of a polytrauma patient following a motor vehicle accident. The patient sustained rib fractures on his left side and had a bilateral pneumothorax. An emergent thoracotomy was performed due to delayed intrathoracic bleeding noted on hospital day 11, and NPWT was applied as described above, in the first case. CONCLUSIONS These cases suggest that damage control thoracotomy with intrathoracic placement of a modified ABTHERA ADVANCE™ Open Abdomen Dressing negative-pressure system may be an effective and life-saving technique with the potential for positive outcomes in these high-risk patients.
• Matthews, M. R., & Fernandez, L. G. (2022). Applications of a new silicone-acrylic hybrid semiocclusive drape with negative pressure wound therapies in a burn center. Wounds : a compendium of clinical research and practice, 34(5), 141-145.
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  It is essential that occlusive drapes provide both an airtight, watertight seal and prevent intrusion of the external environment into a healing wound bed. Removal of an acrylic drape, however, may result in pain, reflex erythema, and a denuding of the epidermis, including the stratum corneum. Recently, a new silicone-acrylic hybrid drape was introduced for use with negative pressure wound therapy. Five unique and varied clinical cases from a burn center that used such negative pressure wound therapy dressings with the silicone-acrylic hybrid drape are presented. These cases highlight the excellent sealing capabilities of this new occlusive drape and minimal pain upon its removal. In addition, this hybrid drape may decrease waste of dressing supply because it is easily reconfigured to its original form and can be repositioned if the initial placement is suboptimal. The drape also maintains a tight seal with repositioning, making it more user-friendly to the clinical provider.
• Ho, K., Arias, S., Roshan, D., Dishner, K., Lardizabal, M., Roth, B., & Matthews, M. R. (2021). A guillotine amputation at the ankle level-how to quickly remove a septic foot: a case report. Journal of wound care, 30(Sup9), S17-S23.
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  As of 2014, diabetes is estimated to affect 422 million people globally. It is well recognised that lower extremity amputations secondary to diabetes have a high mortality rate perioperatively. The purpose of this article is to provide a simple, step-by-step guide to surgeons who need to perform a transtibial amputation. The case report of a 62-year-old female patient with poorly controlled diabetes who developed necrotising fasciitis of the lower extremity and systemic sepsis is used to illustrate the procedure. Knowing how to complete this operation is essential due to its effectiveness in quickly eliminating a source of pedal sepsis.
• Delapena, S., Fernández, L. G., Foster, K. N., & Matthews, M. R. (2020). Negative Pressure Wound Therapy With Instillation and Dwell Time for the Management of Complex Wounds: A Case Series. Wounds : a compendium of clinical research and practice, 32(12), E96-E100.
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  Negative pressure wound therapy (NPWT) dressings are beneficial tools for promoting granulation tissue and wound healing. An NPWT dressing with instillation and dwell time (NPWTi-d) is becoming more frequently used to provide daily, effective wound cleansing between surgical debridement procedures. Either saline or other wound solutions, such has hypochlorous acid wound solution, can be instilled in small volume aliquots to irrigate the wound periodically.
• Fernández, L. G., Matthews, M. R., Ellman, C., Jackson, P., Villarreal, D. H., & Norwood, S. (2020). Use of Reticulated Open Cell Foam Dressings With Through Holes During Negative Pressure Wound Therapy With Instillation and Dwell Time: A Large Case Study. Wounds : a compendium of clinical research and practice, 32(10), 279-282.
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  Negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been utilized in wounds with positive clinical benefits. A reticulated open cell foam dressing with through holes (ROCF-CC) was developed to assist with wound cleansing by removing thick wound exudate and infectious materials, and it may be used when debridement is not possible or appropriate. Use of NPWTi-d with ROCF-CC dressings has been reported with positive outcomes in complex wounds.